|
MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH CC
|
Facility
|
IP
|
$68,962.84
|
|
|
Service Code
|
MSDRG 035
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$68,962.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$68,962.84
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$57,158.58
|
| Rate for Payer: EPIC Health Plan Senior |
$42,339.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$42,339.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$42,339.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$56,735.18
|
| Rate for Payer: Multiplan WC |
$42,496.57
|
| Rate for Payer: Prime Health Services WC |
$42,062.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITH MCC
|
Facility
|
IP
|
$117,889.83
|
|
|
Service Code
|
MSDRG 034
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$117,889.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$117,889.83
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$80,075.52
|
| Rate for Payer: EPIC Health Plan Senior |
$59,315.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$59,315.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$59,315.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$79,482.37
|
| Rate for Payer: Multiplan WC |
$72,646.57
|
| Rate for Payer: Prime Health Services WC |
$71,905.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC
|
Facility
|
IP
|
$55,572.26
|
|
|
Service Code
|
MSDRG 036
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$55,572.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,572.26
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,886.58
|
| Rate for Payer: EPIC Health Plan Senior |
$37,693.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,693.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,693.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,509.64
|
| Rate for Payer: Multiplan WC |
$34,244.97
|
| Rate for Payer: Prime Health Services WC |
$33,895.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CELLULITIS WITH MCC
|
Facility
|
IP
|
$45,719.29
|
|
|
Service Code
|
MSDRG 602
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,719.29 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44,540.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$45,719.29
|
| Rate for Payer: EPIC Health Plan Senior |
$33,866.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$33,866.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$33,866.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45,380.63
|
| Rate for Payer: Multiplan WC |
$27,446.79
|
| Rate for Payer: Prime Health Services WC |
$27,166.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CELLULITIS WITHOUT MCC
|
Facility
|
IP
|
$37,364.17
|
|
|
Service Code
|
MSDRG 603
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,364.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,702.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,364.17
|
| Rate for Payer: EPIC Health Plan Senior |
$27,677.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,677.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,677.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,087.39
|
| Rate for Payer: Multiplan WC |
$16,454.62
|
| Rate for Payer: Prime Health Services WC |
$16,286.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITH CC
|
Facility
|
IP
|
$87,831.52
|
|
|
Service Code
|
MSDRG 472
|
| Min. Negotiated Rate |
$22,650.00 |
| Max. Negotiated Rate |
$87,831.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$87,831.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$65,996.48
|
| Rate for Payer: EPIC Health Plan Senior |
$48,886.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48,886.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$48,886.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65,507.62
|
| Rate for Payer: Multiplan WC |
$54,123.91
|
| Rate for Payer: Prime Health Services WC |
$53,571.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$30,096.00
|
| Rate for Payer: United Healthcare All Other HMO |
$42,113.00
|
| Rate for Payer: United Healthcare HMO Rider |
$24,721.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,650.00
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$147,253.91
|
|
|
Service Code
|
MSDRG 471
|
| Min. Negotiated Rate |
$24,564.00 |
| Max. Negotiated Rate |
$147,253.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$147,253.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$93,829.33
|
| Rate for Payer: EPIC Health Plan Senior |
$69,503.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$69,503.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$69,503.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93,134.30
|
| Rate for Payer: Multiplan WC |
$90,741.42
|
| Rate for Payer: Prime Health Services WC |
$89,815.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,108.00
|
| Rate for Payer: United Healthcare All Other HMO |
$38,993.00
|
| Rate for Payer: United Healthcare HMO Rider |
$34,591.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31,692.00
|
|
|
MS-DRG 42.00: CERVICAL SPINAL FUSION WITHOUT CC/MCC
|
Facility
|
IP
|
$71,770.10
|
|
|
Service Code
|
MSDRG 473
|
| Min. Negotiated Rate |
$22,963.00 |
| Max. Negotiated Rate |
$71,770.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$71,770.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$58,473.47
|
| Rate for Payer: EPIC Health Plan Senior |
$43,313.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$43,313.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$43,313.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$58,040.33
|
| Rate for Payer: Multiplan WC |
$44,226.47
|
| Rate for Payer: Prime Health Services WC |
$43,775.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$42,292.00
|
| Rate for Payer: United Healthcare All Other HMO |
$32,996.00
|
| Rate for Payer: United Healthcare HMO Rider |
$25,065.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22,963.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH CC
|
Facility
|
IP
|
$39,934.31
|
|
|
Service Code
|
MSDRG 787
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$39,934.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,189.53
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,934.31
|
| Rate for Payer: EPIC Health Plan Senior |
$29,580.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,580.97
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,580.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,638.50
|
| Rate for Payer: Multiplan WC |
$19,835.96
|
| Rate for Payer: Prime Health Services WC |
$19,633.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITH MCC
|
Facility
|
IP
|
$48,987.62
|
|
|
Service Code
|
MSDRG 786
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$48,987.62 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,987.62
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$47,802.39
|
| Rate for Payer: EPIC Health Plan Senior |
$35,409.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,409.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,409.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$47,448.30
|
| Rate for Payer: Multiplan WC |
$30,187.36
|
| Rate for Payer: Prime Health Services WC |
$29,879.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$37,703.54
|
|
|
Service Code
|
MSDRG 788
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$37,703.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27,426.89
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,703.54
|
| Rate for Payer: EPIC Health Plan Senior |
$27,928.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,928.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,928.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$37,424.26
|
| Rate for Payer: Multiplan WC |
$16,901.11
|
| Rate for Payer: Prime Health Services WC |
$16,728.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH CC
|
Facility
|
IP
|
$40,235.35
|
|
|
Service Code
|
MSDRG 784
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$40,235.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,832.23
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,235.35
|
| Rate for Payer: EPIC Health Plan Senior |
$29,803.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,803.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,803.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,937.31
|
| Rate for Payer: Multiplan WC |
$20,232.01
|
| Rate for Payer: Prime Health Services WC |
$20,025.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITH MCC
|
Facility
|
IP
|
$55,845.10
|
|
|
Service Code
|
MSDRG 783
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$55,845.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,845.10
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$51,014.37
|
| Rate for Payer: EPIC Health Plan Senior |
$37,788.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,788.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,788.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,636.48
|
| Rate for Payer: Multiplan WC |
$34,413.10
|
| Rate for Payer: Prime Health Services WC |
$34,061.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC
|
Facility
|
IP
|
$37,260.51
|
|
|
Service Code
|
MSDRG 785
|
| Min. Negotiated Rate |
$6,000.00 |
| Max. Negotiated Rate |
$37,260.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,481.03
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,260.51
|
| Rate for Payer: EPIC Health Plan Senior |
$27,600.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,600.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,600.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,984.51
|
| Rate for Payer: Multiplan WC |
$16,318.25
|
| Rate for Payer: Prime Health Services WC |
$16,151.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,587.00
|
| Rate for Payer: United Healthcare All Other HMO |
$12,305.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,716.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,817.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC
|
Facility
|
IP
|
$151,798.28
|
|
|
Service Code
|
MSDRG 837
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$151,798.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$151,798.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$95,957.88
|
| Rate for Payer: EPIC Health Plan Senior |
$71,079.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$71,079.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$71,079.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$95,247.08
|
| Rate for Payer: Multiplan WC |
$93,541.77
|
| Rate for Payer: Prime Health Services WC |
$92,587.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT
|
Facility
|
IP
|
$61,486.91
|
|
|
Service Code
|
MSDRG 838
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$61,486.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61,486.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$53,656.94
|
| Rate for Payer: EPIC Health Plan Senior |
$39,745.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,745.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,745.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53,259.48
|
| Rate for Payer: Multiplan WC |
$37,889.72
|
| Rate for Payer: Prime Health Services WC |
$37,503.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$44,316.36
|
|
|
Service Code
|
MSDRG 839
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$44,316.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,545.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,316.36
|
| Rate for Payer: EPIC Health Plan Senior |
$32,826.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,826.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,826.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,988.09
|
| Rate for Payer: Multiplan WC |
$25,601.07
|
| Rate for Payer: Prime Health Services WC |
$25,339.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC
|
Facility
|
IP
|
$42,900.65
|
|
|
Service Code
|
MSDRG 847
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$42,900.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,522.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$42,900.65
|
| Rate for Payer: EPIC Health Plan Senior |
$31,778.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$31,778.26
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31,778.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42,582.87
|
| Rate for Payer: Multiplan WC |
$23,738.52
|
| Rate for Payer: Prime Health Services WC |
$23,496.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC
|
Facility
|
IP
|
$77,421.00
|
|
|
Service Code
|
MSDRG 846
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$77,421.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$77,421.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$61,120.31
|
| Rate for Payer: EPIC Health Plan Senior |
$45,274.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$45,274.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$45,274.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$60,667.56
|
| Rate for Payer: Multiplan WC |
$47,708.69
|
| Rate for Payer: Prime Health Services WC |
$47,221.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC
|
Facility
|
IP
|
$36,485.22
|
|
|
Service Code
|
MSDRG 848
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$36,485.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,825.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$36,485.22
|
| Rate for Payer: EPIC Health Plan Senior |
$27,026.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,026.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,026.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,214.96
|
| Rate for Payer: Multiplan WC |
$15,298.24
|
| Rate for Payer: Prime Health Services WC |
$15,142.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHEST PAIN
|
Facility
|
IP
|
$34,987.14
|
|
|
Service Code
|
MSDRG 313
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,987.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,627.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,987.14
|
| Rate for Payer: EPIC Health Plan Senior |
$25,916.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,916.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,916.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,727.98
|
| Rate for Payer: Multiplan WC |
$13,327.35
|
| Rate for Payer: Prime Health Services WC |
$13,191.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$1,143,301.24
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$1,143,301.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,143,301.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$560,368.15
|
| Rate for Payer: EPIC Health Plan Senior |
$415,087.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$415,087.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$415,087.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$556,217.28
|
| Rate for Payer: Multiplan WC |
$704,529.93
|
| Rate for Payer: Prime Health Services WC |
$697,340.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$59,968.08
|
|
|
Service Code
|
MSDRG 415
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$59,968.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,968.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,945.53
|
| Rate for Payer: EPIC Health Plan Senior |
$39,218.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,218.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,218.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,553.34
|
| Rate for Payer: Multiplan WC |
$36,953.78
|
| Rate for Payer: Prime Health Services WC |
$36,576.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$106,221.20
|
|
|
Service Code
|
MSDRG 414
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$106,221.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$106,221.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,610.04
|
| Rate for Payer: EPIC Health Plan Senior |
$55,266.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,266.70
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,266.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,057.38
|
| Rate for Payer: Multiplan WC |
$65,456.08
|
| Rate for Payer: Prime Health Services WC |
$64,788.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$44,313.49
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,313.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,538.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,313.49
|
| Rate for Payer: EPIC Health Plan Senior |
$32,824.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,824.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,824.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,985.25
|
| Rate for Payer: Multiplan WC |
$25,597.33
|
| Rate for Payer: Prime Health Services WC |
$25,336.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
